Lung perfusion scintigraphy in pulmonary carcinoma and pulmonectomy

PURPOSE: The surgical treatment is the most successful treatment of non-small cell lung cancer (NSCLC) in oncology practice. Lung perfusion scintigraphy as a non-invasive method for evaluation of the perfusion defect related to tumor localization in lung cancer patients is considered the differentiating line of pulmonary tests to predict post-operative lung function.MATERIALS AND METHODS: We analyzed retrospectively the value of lung perfusion scintigraphy in 10 cases with primary lung carcinoma who had a pulmonectomy (9 left and 1 right pulmonectomy).RESULTS: Changes in affected lung perfusion varied from impaired in different rate to perfusion defect in at least 3 lung segments (presented in 3 of the patients), 4 lung segments (present in 2 of the patients), or parts of segments, or defect affecting whole lobe. Impaired perfusion in a zone with polycyclic outlines in homolateral hilum was present in 7 of the patients. Perfusion indices at localization in the left lung (8 of the patients) were mean = 36,79%, SD=19,35%, SE=6,8%.CONCLUSION: Lung perfusion scintigraphy is a valuable method in the complex of pre-operative examinations to define the extent of the impairments in pulmonary perfusion and predicting the post-operative pulmonary function when pulmonectomy is about to be elaborated. The rate of perfusion changes and the percentage of involvement of the affected lung in the common pulmonary function correlate with survival. The low perfusion in the affected lung is not necessarily a contraindication for operative treatment

Pulmonary perfusion scintigraphy in lung carcinoma and lobectomy

PURPOSE: Most successful treatment of the lung cancer patients is the surgical resection. Lung perfusion scintigraphy is established method in the complex pre-operative diagnostics of lung carcinoma. It is used for selection of candidates for surgical treatment and in determination of operability and in decision on the operation volume.MATERIALS AND METHODS: We analyzed retrospectively the value of lung perfusion scintigraphy in 27 cases with primary lung carcinoma who had a lobectomy. Survival probability was calculated by Kaplan- Meier method. The log rank test was used to compare survival rates between groups.RESULTS: All patients with lobectomy were staged pre-operatively by noninvasive procedures at stages I-IIIA. The lung perfusion scintigraphy demonstrated an enlarged mediastinum at 1 of the patients. Impaired perfusion in homolateral hilum and in the contralateral hilum was found in some of the patients. Changes in affected lung perfusion varied from impaired in different rate to perfusion defect. Perfusion indices at affected lung have mean=48,59%. The survival of patients with Perfusion index less than 49% was mean = 56,333 months, and median = 35 months (3 years). The survival of patients with Perfusion index more than 49% was mean = 99,214 months, and median = 64 months (5.3 years). For I and II stage mean survival time was 120,727 months, and median survival time was 112 months (9.3 years). For IIIA and IIIB stage mean survival time was 48,667 months, and median survival time was 29 months (2,4 years).CONCLUSION: Lung perfusion scintigraphy is a valuable method in pre-operative diagnosis of lung carcinoma in determination of the extent of perfusion impairment in the affected lung and for determination of functional operability. Lobectomy is possible when perfusion in affected lung is over 41%, but the lower perfusion is not surely a contraindication for lobectomy. The extent of perfusion impairment is proportional to survival rate. Patients with lower perfusion impairments have more than 5 years median survival. In postoperative period perfusion scintigraphy shows re-distribution of perfusion in the healthy lung and in the rest of the operated lung. The survival of patients with lobectomy is corresponding to the clinical stage statistically significant

Value of lung perfusion scintigraphy in predicting unresectability of patients with lung cancer and explorative thoracotomy

Purpose: To determine the value of lung perfusion on predicting unresectability of lung carcinoma in patients with exploratory thoracotomy.Materials and methods: We analyzed retrospectively the value of lung perfusion scintigraphy in 25 cases with primary lung carcinoma who had an exploratory thoracotomy (18 right and 7 left thoracotomy), regarding preoperative suggestion of unresectability. In most of these patients other noninvasive diagnostic methods (X-ray and CT) did not indicate inoperability.Results: Only the perfusion lung scintigraphy demonstrated defects near the ipsilateral hilum and/or an enlargement of the mediastinum, displacement of mediastinum, displacement (pulling) of the hilum of the affected lung or a part of it to the mediastinum. At thoracotomy we found an involvement of hilar vessels and the mediastinum by the tumor or by `bulky` nodal metastases. Common peripheral concentric decrease of affected lung perfusion image dimensions, lacking or negligible perfusion of the affected lung also suggest inoperability. Perfusion indices at localization of the tumor in the right lung (15 of the patients) were mean=40,8%, SD=11,02%, SE=2,7%, and at localization in the left lung (6 of the patients) mean=36,27%, SD=10,60%, SE=4,01%.Conclusion: These findings show that in some patients with bronchial carcinoma the perfusion scintigraphy image can suggest a potential unresectability and requires a more extensive staging like mediastinoscopy or thoracoscopy

Different Responses to Water Deficit of Two Common Winter Wheat Varieties: Physiological and Biochemical Characteristics

Since water scarcity is one of the main risks for the future of agriculture, studying the ability of different wheat genotypes to tolerate a water deficit is fundamental. This study examined the responses of two hybrid wheat varieties (Gizda and Fermer) with different drought resistance to moderate (3 days) and severe (7 days) drought stress, as well as their post-stress recovery to understand their underlying defense strategies and adaptive mechanisms in more detail. To this end, the dehydration-induced alterations in the electrolyte leakage, photosynthetic pigment content, membrane fluidity, energy interaction between pigment–protein complexes, primary photosynthetic reactions, photosynthetic and stress-induced proteins, and antioxidant responses were analyzed in order to unravel the different physiological and biochemical strategies of both wheat varieties. The results demonstrated that Gizda plants are more tolerant to severe dehydration compared to Fermer, as evidenced by the lower decrease in leaf water and pigment content, lower inhibition of photosystem II (PSII) photochemistry and dissipation of thermal energy, as well as lower dehydrins’ content. Some of defense mechanisms by which Gizda variety can tolerate drought stress involve the maintenance of decreased chlorophyll content in leaves, increased fluidity of the thylakoid membranes causing structural alterations in the photosynthetic apparatus, as well as dehydration-induced accumulation of early light-induced proteins (ELIPs), an increased capacity for PSI cyclic electron transport and enhanced antioxidant enzyme activity (SOD and APX), thus alleviating oxidative damage. Furthermore, the leaf content of total phenols, flavonoids, and lipid-soluble antioxidant metabolites was higher in Gizda than in Fermer

Second Black Sea Symposium For Young Scientists In Biomedicine March 27-30, 2014, Varna, Bulgaria

Варненски медицински форум (Varna Medical Forum) V. 3, Suppl 1(2014

50 години Катедра „Социална медицина и организация на здравеопазването`

22 Май 201

Abstracts Of The Proceedings And The Posters From The Third Scientific Session Of The Medical College Of Varna

October 2-3, 201